Opening the Patient in Open Access Week; or, the Great Research Hoax

At first glance, The Atlantic’s “Lies, Damned Lies, and Medical Science,” by David H. Freedman (November, 2010), about the inaccuracies, contradictions, reversals, and errors in medical and pharmaceutical research, looks like something out of the National Enquirer: can this hoax be, to this extent, true? Alas, Dr. John Ioannidis’s 2005 article, published in JAMA, goes unchallenged – its conclusion: “Contradiction…[is] not unusual in highly cited research of clinical interventions and their outcomes.” What this means is that 90% of your doctor’s advice about what you should or should not be doing health-wise is probably based on faulty or biased research. The timing of The Atlantic article, arriving in mailboxes in the middle of the international Open Access week, couldn’t be better. “Though scientists and science journalists are constantly talking up the value of the peer-review process, researchers admit among themselves that biased, erroneous, and even blatantly fraudulent studies easily slip through it,” reports Freedman.

Sponsored by SPARC, the Scholarly Publishing and Academic Resources Coalition, Open Access week seeks to raise awareness of Open Access initiatives worldwide. It’s possible that the Open Access movement will alleviate many of the pressures on researchers that have led to the problematic results described in The Atlantic article, primarily, as Freedman quotes Ioannidis, because “at every step in the process there is room to distort results, a way to make a stronger claim or to select what is going to be concluded.” But why? Why would researchers not want to discover what’s really going on? Because, Ioannidis says, “There is an intellectual conflict of interest that pressures researchers to find whatever it is that is most likely to get them funded.” It’s that conflict of interest that Open Access has the potential to cure.

Our friends the physicists have been both dipping into the infinite cookie jar of funding and publishing open access style for some time. It was at the FQXi Community site that we first became aware of Garrett Lisi’s paper “An Exceptionally Simple Theory of Everything.” But if Ioannidis is right, and as the number of papers on string theory might suggest, most research probably reduces to simply that most everything is wrong. But, no worries, for Ioannidis concludes, at the end of Freedman’s piece in The Atlantic, that “Science is a noble endeavor, but it’s also a low-yield endeavor. I’m not sure that more than a very small percentage of medical research is ever likely to lead to major improvements in clinical outcomes and quality of life. We should be very comfortable with that fact.” Buckminster Fuller was very comfortable with that fact. Fuller thought it was necessary to pay for all the researchers on the bet that one of them would come up with a viable idea to pay for all the others and then some.

If science is a low-yield endeavor, what’s poetry? Still, Open Access holds the potential for improving the quality and honesty of research, publication, access, and discussion of scholarly papers in the sciences and the humanities. The irony of course is the cost associated with behind the pay wall journals coupled with the findings of Ioannidis. And why would the problem be any different in the Humanities? But will Open Access remedy the research problems discussed by Ioannidis? It’s possible, since the peer review process changes – with more eyes on the product, and the strength of closed and biased editorial voices of certain periodicals and coteries of peers is quieted down. What should we be reading? Open Access has the potential to open the walled cherry orchard to everyone with an appetite, for is 90% of our poetry critics’ advice about what we should be reading also based on faulty and biased research? Ioannidis and his meta-researchers have uncovered a hoax, one that’s been a long time in the making and continues to sicken the patient.